International Association for Hospice and Palliative Care 

Subject: IAHPC Newsroom 2005; Volume 6, No 4, April

William Farr, MD
Editor

Liliana De Lima, MHA
Coordinator

Alou Design
Layout and Distribution

Dear Members and Colleagues:

The April, 2005 issue of the IAPHC Newsletter is now on our website at URL:
http://www.hospicecare.com/newsletter2005/apr05/index.html

PDA version is located here:
http://www.hospicecare.com/newsletter2005/apr05/pda.html

The Table of Contents:

Message from the Chair and Executive Director

Article of the Month

The Terri Shiavo Case in the US

Reports on the 6th Asia Pacific Hospice Conference

2nd Global Summit of National Hospice and Palliative Care Associations

Book Reviews

Regional News: Asia and a Report of the Training the Trainers Course in India

Webmasters Corner

Editor’s Notes

Meetings

Regards,

Kathleen Foley, MD Chair
William Farr, PhD, MD Vice-Chair and Editor

Message from the Chair and Executive Director

Dr. Kathy Foley and Liliana De Lima

Dear Readers:

Until next month,

Kathy Foley, MD
Chair, Board of Directors

Liliana De Lima, MHA
Executive Director

Article of the Month

Dr. Ripamonti

The correlation between fatigue, physical function, the systemic inflammatory response, and psychological distress in patients with advanced lung cancer

Author(s): Brown D.J.F, McMillan DC , Milroy R.

Abstract:  Cancer 2005; 103: 377-82

Fatigue is a frequent and devastating symptom in advanced cancer patients with a negative impact on their basic daily life activities.

Little is known about the mechanism that determines the intensity of the symptom and it is not yet clear if there is a correlation between fatigue, objective physical function and psychological distress.

The aim of this study was to evaluate the relationship between fatigue, physical function, the systemic inflammatory response, and psychological distress in patients with metastatic or locally advanced lung cancer.

38 patients were assessed (18 with metastatic disease and 20 with locally advanced cancer) recruited from two specialist palliative care centers and an associated hospital. The control group was composed of 15 age-matched and gender matched healthy volunteers. Patients were excluded if they had received surgery or had undergone chemo or radiotherapy in the previous month or if they had an active connective tissue disease.

The patients and the control group were assessed for:

• fatigue by means of FACIT-Fatigue (FACIT-F), and 3-item Fatigue subscale of the EORTC QLQ-30
• weakness by means of a 10-cm visual analogue scale
• anthropometry, body composition: height and weight, body mass index (BMI), triceps skin-fold thickness and thigh skin-fold thickness, midarm and midthigh circumferences
• physical function: functional ability was assessed by means of the Karnofsky performance status (KPS), hand-grip strength in the dominant hand with a grip dynamometer, the chair-rise time was measured on a hand-held digital stopwatch
• psychological distress by means of the Hospital Anxiety and Depression (HAD) scale
• type of drugs taken (opioids, benzodiazepines, antidepressants, NSAIDs, corticosteroids)
• white blood cell count, haemoglobin, creatininekinase, albumin, and C-reactive protein

With respect to the control group, cancer patients had higher levels of fatigue, weakness and psychological distress (p<0.001). Moreover cancer patients were thinner, had lower levels of haemoglobin and creatinekinase and higher CRP levels, lower KPS, lesser grip strength, longer chair-rise times, higher HAD scale scores (all p<0.01). Significant correlations (all p< 0.001) were found in the cancer patients between FACIT-F and the Fatigue subscale of the EORTC and between the KPS and the chair-rise time. The correlation between fatigue and the use of drugs involved only those patients on benzodiazepines who reported greater fatigue compared to those who were not taking such drugs (p<0.01).

As fatigue increased, there were lower KPS, higher weakness and higher HAD scores (p<0.001) and slower chair-rise times (p<0.01). In a multiple regression analysis, only KPS, weakness and HAD scores were correlated independently with fatigue (p<0.001).

Why I chose this article

The results of this study, even though carried out on a small number of advanced cancer patients, demonstrate that fatigue is correlated with KPS and psychological distress. Weight loss or anaemia is not principally the causes of fatigue, contrary to the results of other studies. Moreover, this study points out that both fatigue and performance statuses are related to a simple evaluation of a physical function such as the time taken to rise from a chair.
Regards,

Carla Ripamonti, MD
Member of the Board of Directors, IAHPC

Please visit the following link to read past Articles Of The Month:
http://www.hospicecare.com/AOM/aom_main.ht

The Terri Shiavo Case in the US

I had originally planned to write a description of the comprehensive hospice and palliative care program that Alive Hospice offers in the Middle Tennessee area, but, as circumstances would have it, the most crucial thing happening right now in the United States is the controversy over the Terri Schiavo case. As one who has been intimately involved in end-of-life ethics for the past 20 years, I feel compelled to address this issue. I’ll begin with a history of the case.

Terri Schiavo is a 41-year-old woman who suffered a cardiac arrest at age 26 that is thought to be a result of an eating disorder. She was deprived of oxygen for 10 minutes prior to being resuscitated. Over the past 15 years she has been unconscious, with apparently only brain stem functions intact for that entire time, and she has been sustained via a feeding tube. Michael Schiavo, her husband of five years at the time of her collapse, states that Terri’s wishes about not wanting to live like she is now were made clear to him after they watched a similar situation on television prior to her attack.

In 1993, Bob and Mary Schindler, Terri’s parents, fought with Michael over a medical malpractice award of $1 million dollars given to the Schiavos. Both parties disagreed about Terri’s wishes, and, in 1998, Michael began battling in court over the right to remove the tube so that Terri’s death could occur naturally. The malpractice award given to the Schiavos has since been almost totally consumed by the costs of medical care and attorneys’ fees.

In 2001, and again in 2003, the courts decided that the tube could be removed, but those decisions were later reversed. In the 2003 decision, the governor of the state of Florida, where Terri resides, intervened in the case and ordered the tube reinserted. That order was later deemed unconstitutional. The courts then reinstated the order to remove the tube, and on March 18, 2005 , the tube was removed. The United States Congress intervened by passing a law allowing the parents to take their plea to federal court. After the federal appeals court denied their request to reinsert the feeding tube, the Schindlers filed an appeal with the Supreme Court, and that appeal was also rejected.

Terri remains without the feeding tube at the time of this writing, and she is receiving care from a hospice in Florida. That hospice has remained steadfastly supportive of her, and the staff has consistently communicated that it is not their role to decide or opine what the right thing to do is in regards to the feeding tube. The hospice’s role is to provide excellent comfort care to Terri and support for her family members in whatever ways are appropriate. The staff has been doing this since the time the first feeding tube was removed and doing so under a microscope. In my opinion, they have been phenomenal role models of hospice and palliative care.

Regarding some of the ethical issues involved in this case, there are several that are troubling and several that provide opportunities. Those I find most troubling include: 1) Confusion on the part of the general public between euthanasia and allowing death to occur from natural causes – although this is arguably a gray area, there is general agreement from ethicists and religious leaders alike that sustaining life by artificial means is not required to be maintained and that removal of such artificial devices or means does not constitute euthanasia; 2) Misunderstanding on the part of the general public about suffering occurring from starvation or dehydration – medical experts generally agree, and have evidence, that suffering is not present when food and fluids are not forced; in fact there is evidence to the contrary that endorphins produce a sense of euphoria in these cases, and for those who are imminently dying forcing food and fluids produces distressing symptoms; 3) Governmental intervention in private concerns – for purposes of this article I am assuming that the court rulings are evidence of sufficient testimony to ascertain Terri’s wishes and that she would not have wished to be kept alive by artificial means. From my personal perspective this situation is highly personal and intimate. I believe that the United States legal system is an appropriate forum for the argument. It is inappropriate, however, for the government to interfere with due process to enforce their personal beliefs. We do pride ourselves in America on having certain inalienable rights as individuals. I think we are dangerously close to having government dictate personal morals in this case.

On the opportunity side, I am pleased to see the amount of conversation that has been generated in the media and in the general public about the issue of how one would wish to live at the end of life. In a society that normally denies death and fails to discuss it in any way, this has made it much more personal to us all. As we watch the struggles this family endures, we begin to realize the gift we can each give our loved ones just by having the conversation and documenting our wishes for all to see. I hurt for the parents and husband of Terri Schiavo, and certainly for her, but I know that they are inadvertently giving us all a tremendous gift by living in this glass house. And I am ever grateful for my calling in the hospice field - to walk with those who are making the ultimate transition is a blessing. I’m glad that Terri has hospice walking with her on this journey.

The opinions expressed here are the personal views of Jan Jones and are not those of Alive Hospice, or IAHPC. Ms. Jones is President/CEO of Alive Hospice in Nashville and a Member of the IAHPC Board of Directors http://www.hospicecare.com/Bio/j_jones.htm

Reports on the 6th Asia Pacific Hospice Conference
March 16 -- 19, 2005

By Ednin Hamzah, MD

Seoul 2005 was the venue of the 6th Asia Pacific Hospice Conference hosted by the Korean Society for Hospice and Palliative Care in collaboration with Asia Pacific Hospice Palliative Care Network. An attendance of nearly 1200 delegates from all over the world was a testament to an attractive programme developed by the organising committee led by Professor Kyung Shik Lee.

A theme of ‘Changing Society and Human Life with Hospice Palliative Care’ set the scene for the proceedings for the days ahead. Although there is great variability in the Palliative Care settings in the countries of the Asia Pacific, the conference brought together common themes on issues and the sharing of knowledge. There was a wonderful pre-conference programme where Kyung Shik Lee, Cynthia Goh and Ian Maddocks addressed the theme of the conference.

The Asia perspective of many palliative care issues was apparent through many of the presentations. It was enlightening to be made aware that problems and solutions may be presented and dealt with in many different ways in order to achieve the desired outcomes. The presentations both oral and in poster form on cultural, psychosocial and ethical issues were particularly interesting. The 4 plenary and 10 symposium sessions covered a wide range of palliative care topics and issues including controversies.

The conference also cultivated a spirit of togetherness and networking for many in the region. Many palliative care services in the region may be working in relative isolation.The awareness of APHN 2005 allowed many to begin to search for resources to improve themselves. The wonderful culture and hospitality of the Korean people throughout the conference made for a most memorable meeting.

To read Dr. Hamzah’s biography go to URL: http://www.hospicecare.com/Bio/e_hamzah.htm

By Ednin Hamzah, MD
CEO/Medical Director Hospis Malaysia
Council Member Asia Pacific Hospice Network (APHN)
Member of the IAHPC Board of Directors

2nd Global Summit of National Hospice and Palliative Care Associations March 2005, Korea

By Nick Pahl of Help the Hospices, UK

The declaration (and linked press release) from the summit is available at www.hpc-association.net. National associations are encouraged to use the Korea declaration for advocacy with Governments etc. and to officially ratify it. The summit is being written up by the International Observatory on End of Life Care. Useful tools for national hospice and palliative care organisations will be part of the report - including tools for advocacy and organisational development. A submission by the advocacy group is also planned for the WHO World Health Assembly in May 2005. A follow up meeting of national association colleagues particularly from Europe is occurring at the EAPC conference on 9th April 2005 6-8pm ( Eifel room) to which all relevant individuals are invited. The organisers were really pleased with the positive feedback from participants - the organizing committee members are Dr Cynthia Goh ( Singapore ) ­co- Chair; David Praill (UK) ­ co-Chair; Stephen Connor (USA); Sharon Baxter ( Canada ); Dr Daniela Mosiou ( Romania ); Dr Faith Mwangi Powell ( Uganda ); Dr Liz Gwyther ( South Africa ); Dr Roberto Wenk ( Argentina ), Professor David Currow ( Australia ) Dr Dinesh Goswami ( India ). They are planning to meet in November to explore future plans for the network - including the 3rd global summit meeting.

For further information on this and the workgroups (on quality of care, advocacy (including drugs issues), governance, education and training, funding, world hospice and palliative care day, children’s services, organizational development and information issues) please contact Nick Pahl on [email protected]

By Nick Pahl of Help the Hospices, UK

Book Reviews

Roger Woodruff, MD

TUBERCULOSIS
A foundation for nursing and health care practice

Robert J. Pratt, John M. Grange and Virginia G. Williams

Hodder Arnold, 2005; 352 pp; RRP £20, $US38

The World Health Organization estimates that the number of new cases of tuberculosis will rise from 8 million in 1997 to 10.2 million in 2005. Frightening numbers, especially given the deadly synergy between tuberculosis and HIV infection.

This comprehensive new book covers all aspects of the disease. The introductory chapters cover epidemiology, microbiology, transmission and diagnosis. Next there are chapters on the clinical features of pulmonary and extra-pulmonary tuberculosis. The last eight chapters describe in detail the treatment of tuberculosis, the importance of adherence to therapy, the individualized care of patients, nurse-led case management, and infection control. The approach to treatment is holistic and there is good discussion of symptom control and palliative care.
Anyone involved in treating tuberculosis will benefit from this book, whether they live in rich countries or poor. Nurses and other health care professionals in developing countries may need to adapt some of the recommendations to suit local needs and the availability of resources, but the principles are the same. This book contains an enormous amount of information but is well organized and the material clearly explained.
Find our more about this book here

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

CANCER IN CONTEXT:
A Practical Guide to Supportive Care

James Brennan in collaboration with Clare Moynihan

Oxford University Press 2004; 424pp; ISBN 0-19-851525-1
RRP £29.95 $US52.50

Health care professionals who work in both palliative care and medical oncology have long advocated the need for the principles of palliative care, with its multiprofessional holistic approach to all aspects of physical and psychosocial suffering, to be applied earlier in the course of the cancer illness and not reserved until the patient has advanced or terminal disease. The UK is now leading the way, introducing such care under the banner ‘Supportive Care’.

In the introduction, this book is described as ‘a guide for health care staff who support patients and their families through the many changes and challenges that cancer entails.’ ‘[It] is about the impact of cancer on people’s lives and the vital role that health care professionals play in shaping this experience and minimizing the distress involved.’

The approach used differs from traditional psycho-oncology, with its preoccupation with quantifying psychological and psychiatric morbidity, and underlines the need to understand people’s distress in the context of their personal, social and spiritual life. Various chapters describe the management of suffering in human context, in the personal context, in the context of the patient’s family and carers, in the social context, and in clinical context. The last two chapters deal with communication and with the care of the professional caregivers.

And in case you think this is all just more psychobabble, the authors note that ‘Psychosocial experts on their own have very little effect on the distress of cancer; it is the caring hands and the listening ears of doctors, nurses and radiographers that will always have the greatest impact on how people regard their illness.’ As one who works in both medical oncology and palliative care, the type of care outlined in this book is long overdue and, if it can be successfully introduced into busy oncology services, will be a quantum improvement in the care our patients receive.
Find our more about this book here

Roger Woodruff
Medical Oncologist and Director of Palliative Care,
Austin Health, Melbourne, Australia
(April 2005)

Regional News:

Asia News

Reported by Dr KS Chan, Hong Kong

1. The 6 th Asia Pacific Hospice Conference was held in Seoul , Korea from 16 th to 19 th March 2005 . The theme of the conference was “ Changing Society and Human Life with Hospice Palliative Care”. There were 1,200 participants from 28 countries and 58 invited speakers made their presentations at 4 plenary sessions, 12 symposia, a controversy session, and a workshop. Two hundred and sixty-six free papers were presented at 12 oral and 2 poster sessions. The themes of the plenary sessions included: Changing Society and Human Life with Hospice Palliative Care, Cross-Cultural Differences in Ethical Issues of End-of-Life, Update in Pain & Symptom Management and Service Development.

Besides, the Second Global Summit of National Hospice and Palliative Care Associations was held immediately before the APHC 2005 in Seoul , Korea from 15 - 16 March 2005. After the meeting, a Korea declaration on Hospice & Palliative Care March 2005 was drafted & signed by palliative workers from supporting countries.

The 5 th council of Asia Pacific Hospice Network (APHN) was elected on 17 th March 2005 with Dr Enoch Lai ( Taiwan ) as Chairman, Dr Cynthia Goh ( Singapore ) as Honorary Secretary, Ms Yvonne Siu ( Hong Kong ) as Honorary Treasurer.

• A series of short training course will be held by Hospis Malaysia , Kuala Lumpur , Malaysia . The details are as follow:

May 28-29: Pain & Symptom Management 1

July 16-17: Pain & Symptom Management 2

Sept 23-25: Palliative Care Symposium

Nov 19-20 Grief & Bereavement

Interested individual please contact Dr Ednin Hamzah: [email protected]

• A one day bilingual (English & Cantonese) local Palliative Care Symposium will be held by Society for the Promotion of Hospice Care in Hong Kong on 25 th June 2005 . Topics of presentation include: Coping with a life limiting illness for young and adult patients, Family coping with anticipatory grief, Cost of caring: compassion fatigue and burnout, Quality care at the last 48 hours, Nurse’s Role in Ambulatory Palliative Care. Moreover, there are four afternoon workshops on Photography, Relaxation: guided imagery, music therapy and Anticipatory grief. Attendants should understand Chinese.

Interested individuals please contact Ms Faye Chan: [email protected]

Dr. Chan is a member of the IAHPC Board of Directors. To read his biography go to URL: http://www.hospicecare.com/Bio/ks_chan.htm

India

Report of the Training the Trainers Course held in January 2005

Dr. Mallika Tiruvadanan, Chennai

I attended the six day Training Trainers Course with 16 other colleagues from all over India and one from Nepal . It was held from the 10 th to the 15 th of January 2005 in the congenial atmosphere of the Auditorium Conference Hall Area at the Tata Memorial Hospital (TMH), Mumbai.

The course was initiated by Pallium India , a non-governmental organization; but the bulk of the organization (including finding funds) was provided by Dr Maryann Muckaden and her team from TMH. The faculty included Dr Robert Twycross from Oxford , Dr Ramnarayan and Dr Sudhakar Nayak, two medical educationists from Manipal, Dr Reena George from Vellore , Dr Maryann Muckaden and Dr Gayatri Palat and Dr M.R.Rajagopal from Kochi .

At the outset, the objective of the training course was made clear – to make us more effective teachers. Dr. Sudhakar Nayak explained the need to be effective not only in our professional but also in our personal lives. Growing only in part is akin to developing cancer.

To be effective we should (a) understand needs (of patients / students), (b) possess communication skills and (c) find out if those taught have understood. Teaching is effective only if it leads to effective learning.

Three things that will help us all to be effective are knowledge, skills and attitudes, which is the harmony of the head, hands and heart. We should create an atmosphere of love and trust, develop empathetic listening and facilitate change of behaviour (including one’s own). It is better to describe someone’s behaviour rather than be judgmental. It is also important to silence the ever active mind every now and then, as it is in the gaps of silence that we find ‘Muktha’ or liberation. This ultimately leads to everlasting happiness and helps us become more effective in our multiple roles in life.

Dr. Ram Narayan next described how an effective lecture should be given. Students’ silence does not always mean they have understood everything. Giving too much information is hard to digest. One must “uncover” the salient aspects, reinforce important points, be creative and carefully prepare so that we profess and not confess, give take home messages and references. He also explained how visual aids should only facilitate our teaching and not hinder our presentation. The sessions on how speeches such as welcome address, master of ceremonies and vote of thanks should be given were very useful for public speaking.

Dr. Reena and Dr Gayatri next taught us how we can effectively teach communication by using some simple exercises. Importance of ground rules for Role Play was explained. A practical exercise reinforced the importance and also helped to understand how to be a good facilitator. Dr. Reena also discussed how a student could learn from the teacher through modeling, mentoring and reflecting. The role plays done by faculty and the participants made the learning process easy.

Dr. Rajagopal explained how to conduct small group work effectively. Proper planning, appropriate environment, self-introduction, ground rules, ice-breakers, negotiating agenda and defining objectives will facilitate this. He brought out the important duties of a group leader and how the latter should facilitate when handling different types of people in the group. He conducted the ‘gold fish bowl’ exercise to bring out the important features of a group discussion.

Dr. Rajagopal suggested including ‘Pharmaco-economics’ in our teaching sessions. The session on journal club was food for thought. He said that all conclusions by authors of papers in journals may not be correct and so we need to evaluate the methods and results before embarking on testing them on patients.

Dr. Gayatri gave a talk on controversies over Coxibs.. This talk was given more with the idea of suggesting to us to include such thought provoking topics of current interest in our future teachings.

Dr. Robert Twycross taught us how effective teaching should be Informative, Interactive and ‘Infectious’ (infect with enthusiasm). He said the aim of teaching is to improve clinical practice. A good session should be tailored to the audience and not be the same every time. He also presented ‘What’s new in Therapeutics’ and discussed a questionnaire, which was circulated to us previously.

He explained the various points in making a presentation legible, simple and correct. He made us chart out a programme for conducting a two day seminar or CME incorporating all that had been taught to plan in the correct manner, like target audience, objectives, topics with details, time table and take home messages.

Altogether, the Training Course was very useful and stimulating to both our heads and hearts. Education in palliative care has progressed and is spreading in a large way in our country too. All of us who had attended the Course have had some experience in Palliative Care in the clinical and teaching fields. But we realised that we had reached a point where we felt an acute need to improve our teaching methods and skills. This course turned out to be the answer to our questioning minds.

There is certainly a need for such courses on a regular basis now in our country to enable the trained to teach better and keep up a momentum of spreading education far and wide ultimately benefiting the needy.

Dr. Mallika Tiruvadanan, Chennai

Dr. Mallika Tiruvadanan is the organizing secretary of Indian Association for Palliative Care’s conference February, 2006

Webmasters Corner

Anne Laidlaw

Welcome to the Webmaster's Corner!

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Featured IAHPC Section:

Pain & Palliative Care Assessment and Research Tools
We have compiled a list of assessment and research pain and palliative care tools available for free as a service to the palliative care community in the World.
http://www.hospicecare.com/resources/pain-research.htm

Link to the IAHPC:

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Visit our how to link to us section on our donate page.
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Visit our Book & Video Shop for your hospice & Palliative care needs.
2 new titles with reviews added this month! See Book Reviews in this newsletter.

Coming Events! Do you have a Hospice & Palliative Care event you wish to promote?
A new year is here please visit our Future Events section to view events and add your event to our website. 4 new listings added this month!

Did you know?
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Visit our Book & Video Shop for your hospice & Palliative care needs.
5 new titles with reviews added this month! See Book Reviews in this newsletter.
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Coming Events! Do you have a Hospice & Palliative Care event you wish to promote?
A new year is here please visit our Future Events section to view events and add your event to our website. 4 new listings added this month!
http://www.hospicecare.com/announce.htm

Drop by often & don't miss out!

Until next month!
Anne Laidlaw
IAHPC Webmaster

Comments/Questions about our website?
Contact us here: http://www.hospicecare.com/contact.htm

Editor’s Notes

By William Farr, MD
Newsletter Editor

IAHPC’s Clearing House Program
Responses from Recipients  

“Dear Ms De Lima:

Greetings from St. Luke's Palliative Care Unit and Palliative Care Team and the entire St. Luke's Hospital. This is to say a word of thanks for the timely donation of books and journal publications we received that IAHPC has donated as part of the Clearing House Program. I am glad that IAHPC is supporting St Luke's on its effort to run Palliative Care Programs. We are looking forward to benefiting from these donations.

Yours truly,

T.O.T. Mac'osano
ARV/Palliative Care Clinical Coordinator
Zomba , Malawi ”

-----------------------

“Dear Ms De Lima:

We cannot thank you enough for your laudable efforts with the IAHPC Clearing House Program. Considering the dearth of health information and textbooks in developing countries, your gesture in sending us some useful texts and journals cannot be overemphasized. Our program is just developing and approaches this with lots of interest and enthusiasm. Needless to say, those involved have a thirst for the new knowledge and skills. Your donations came at the right time.

Apart from efforts being put in place to establish Palliative Care services in this centre, no prior formal Palliative Care services exists in Ogun-State, Nigeria However, our Centre has been trying its best, in spite of the meager resources, to render voluntary services to terminally ill patients with HIV/AIDS and cancer.

Thanks for the encouragement.

Dr. Folaju O.Oyebola
Initiator & Chairman FMCAbeokuta Hospice and Palliative Care Services.
Idi-Aba, PMB 3031,SAPON, P.O
Abeokuta . Ogun-state Nigeria . 110001”

-------------------

“Thanks for Support. IAHPC doing a great job

Your parcel was a very pleasant surprise. These are very good and useful materials. We need this kind of literature a lot.

Luz Elena Caceres, MD”

------------------

“Dear Ms De Lima:

The donation of books and journals was really very useful and different sources of information in palliative care are crucial for our development.

Thanks you very much

Dr Vilinis Sosars , Latvia ”

IAHPC University Award: University of Bristol ( UK )

“Dear Liliana

Thank you very much indeed for your email of 28 February about the IAHPC University Award.  We are obviously delighted to have won this prize and are grateful to the Board of the IAHPC.  The recognition by IAHPC is very important to us and we shall certainly ensure that the University authorities are made aware of this.

The University of Bristol has been extremely supportive over the years as is evident from the educational programmes that the Department has been able to develop but as with all things we need to continually strive to be at the forefront so that palliative care continues to have a high profile, particularly in the undergraduate curriculum.

As is evident from our application the key person involved in the development of our educational programmes for medical students and doctors is Dr Karen Forbes….

(Photo of Karen Forbes)

With best wishes

Yours sincerely,
Geoffrey Hanks”

Clarification of the information presented in IAHPC’s March, 2005 newsletter about Bristol University ’s award. We should have stated “The University also provides a Master of Science degree in palliative medicine for qualified doctors who have experience of working in palliative care and who wish to pursue a higher degree involving a research dissertation".

The European Association of Palliative Care (EAPC) Task Force on the development of palliative care in Europe

A request of information:

The EAPC Task Force on the development of palliative care in Europe is seeking contacts to act as “key collaborators” and as “expert informants” to help them gather information on palliative care in the following eight countries:

1. Azerbaijan      3. Kyrgyzstan      5. San Marino      7. Turkmenistan

2. Estonia      4. Monaco      6. Tajikistan      8. Uzbekistan

We aim to explore, assess and comprehensively summarize the current state of the development of palliative care in the 52 countries that constitute the European region.

We gather information on palliative care via a range of research methods, including a systematic review of the literature, an analysis of existing palliative care directories and two surveys. The first survey is conducted amongst “expert informants” and it explores views on the national development of palliative care (qualitative survey). The second one is conducted amongst “key collaborators” and it looks at figures or estimates on the availability of palliative care resources (quantitative survey) in each studied country.

Our ultimate goals are to produce

1) a country by country report for the 52 participating countries

2) an atlas of palliative care developments in the European region

The Task Force plans to disseminate the final results in several ways, including publications in palliative care journals; conferences’ proceedings; presentations, and web-sites. All participating “key collaborators” and “expert informants” will be acknowledged as contributors to the project in all publications, and we hope they will remain as possible “contacts for information” about palliative care in their countries in future researches on the nationwide span of the discipline.

If you would like to contribute to this project or for any further information, please contact:

Dr. Silvia Paz
the EAPC Task Force research assistant

Conract Information:
e-mail: [email protected]
telephone: +34 ­ 964 281933
fax: +34 ­ 964 728214

Mail address:
Avenida del Puerto 20, 3 “6”
12100 Castellón (Grao)
Spain

Meetings

To National Association Leads March 11th, 2005

Dear all ,

National Hospice and Palliative Care Association’s Aachen EAPC conference meet – Saturday April 9, 2005  from 6pm – 8pm at the Eifel room

We are pleased to invite you to a meeting of national association colleagues on Saturday 9 th April 2005 at the Eifel room, at the EAPC conference in Aachen (see http://www.eapcnet.org/Aachen2005/) at 6pm.

A buffet dinner will be available from 6pm, followed by a short presentation on the Korea 2005 summit and discussion on National Association issues. The main aim is to create an opportunity for networking, hearing what joint working is currently occurring between national associations and what lessons can be learnt from each other and how we might be able to support each other. We will also be discussing what we are all doing for world hospice and palliative care day – 8th October 2005 - www.worlday.org

This meeting is open to anyone officially involved with a national association or an international centre of excellence.

This meeting follows the two meetings of representatives from hospice and palliative care umbrella bodies or National Associations held at The Hague in March 2003 and Korea in 2005.

So that food can be arranged, please confirm your intention to attend. Please contact Nick Pahl on + (0) 207 520 8236 or [email protected].

Please put this date in your diary and let us know if you can make it or have any questions.

Yours sincerely

David Praill
Chief Executive
Help the Hospices, UK

The American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Care Nurses Association: A call for abstracts for the February 2006 Annual Assembly

The 2006 Annual Assembly will be held February 8-11, 2006 in Nashville, TN. The first call for workshop and concurrent session presentations opened today and will remain *open through ** May 2, 2005 *.
http://aahpm.confex.com/aahpm/2006/ for the link to the abstract submission web site. All abstracts submissions must be completed and submitted through the AAHPM web site.

Hospice & AIDS Care Seminar Tour to Namibia during May 16-27

Namibia in southwest Africa will be the next locale in a series of seminar tours offered by Peter Sarver since 1996 for health care professionals wanting to learn more about the impact of the HIV/AIDS epidemic. The 15-person delegation will include a variety of practitioners. Persons interested in hospice and palliative care will dialog with hospital and home based care providers about the expansion of such services in a resource- constrained country. More than 230,000 of the 1.7 million-population are living with HIV. Visits to program sites and patients homes will be among the activities. Mr. Sarver recently completed 25 years as Hospice CEO in Syracuse and has been to Africa on 14 previous occasions. Registration for the trip is open by requesting more info from [email protected]. The trip includes a two-day safari at Etosha National Park .

Spiritual Well Being: The Individual, the Community and Health Care Institutions

Sponsored by John Hopkins University , the John Hopkins Hospital Dept of Pastoral Care and the Institute for John Hopkins Nursing

May 9 - 11, 2005

Information and registration:

John Hopkins University
Office of Continuing Medical Education
PO Box 64128
Baltimore , MD 21264-4128
USA
www.hopkinscme.net

William Farr, MD
Newsletter Editor
www.hospicecare.com

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****Thanks to all contributors to this issue.****

7 Ways To Help The IAHPC
https://www.hospicecare.com/give/donate.html

William Farr, MD
IAHPC Newsletter Editor
www.hospicecare.com

© 2005 IAHPC Press

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